If you have ever suffered from a stuffy nose, chances are you are familiar with over-the-counter decongestants like Sudafed PE, Benedryl Allergy D Plus Sinus and Vicks DayQuil Cold and Flu Relief. What they had in common is the ingredient phenylephrine, which as of September 2023, the Food and Drug Administration (FDA) says does not work. Products are being pulled from the shelves.
So, what is a person with a stuffy nose to do? What’s the cure? Please discuss any drug usage with your doctor, but we have some good news, including non-medical interventions.
Phenylephrine Can Be Used in a Nasal Spray
Phenylephrine is still considered effective when administered as a nasal spray. The recent FDA panel evaluation specifically scrutinized the efficacy of oral phenylephrine. Research has shown that when taken in pill form, a significant portion of the drug is metabolized in the body before it reaches the nasal passages to relieve congestion. In contrast, when used as a nasal spray, phenylephrine is directly delivered to the affected area.
Most doctors advise against using decongestant nasal sprays for more than three days, as prolonged use can result in rebound congestion. Oxymetazoline, a common ingredient in over-the-counter nasal sprays such as Afrin and Zicam, is another viable alternative, although it can also lead to rebound congestion if used excessively.
Look Into Pseudoephedrine
Pseudoephedrine, the decongestant commonly found in the classic Sudafed formulation can alleviate nasal congestion. You will have to ask the pharmacist for pseudoephedrine as it is typically kept behind the counter and has been since 2006, because it can be used in the production of methamphetamine.
Pseudoephedrine can raise blood pressure; ask your doctor for alternatives such as the oral antihistamines Zyrtec, Allegra, and Claritin.
Nasal Congestion and Children
For very young children, doctors often suggest a bulb syringe or nasal aspirator, which manually removes nasal congestion. A doctor or nurse can show you how to use one safely.
Children have narrower nasal passages and alleviating congestion can be a challenge. According to FDA guidelines, it is advised not to administer any cold or flu medication containing decongestants or antihistamines to children under the age of two, given the potential for dangerous side effects. For children aged two to four, the FDA recommends exercising caution.
Non-Medical Ways To Alleviate Congestion
For children and adults, there are several non-medical ways to treat congestions:
- Stay hydrated
- Get ample rest
- Use a room humidifier
- Raise head during sleep
- Taking a hot shower
- Minimize contact with pollen
- Consider an air purifier
- Eat some spicy foods
- Try pressure on sinus pressure points. Try 1 minute of massage or gentle pressure to above the bridge of your nose between your eyebrows; the top of your nose just below the ridge of your eyebrows; or feel around for the soft, sore areas on your cheeks below your eyes.
- Apply warm, wet towels to the face to relieve swelling and inflammation
- Try a Neti-Pot, always using sterile water in a clean pot
Two More Surprising Ideas
Try eucalyptus oil. According to Medical News Today, this essential oil can relieve congestion symptoms, and help kill germs. One method involves applying it to tissue paper and placing it nearby while sleeping, or alternatively, adding it to hot water and inhaling the resulting steam. It’s important to note, however, that applying the eucalyptus oil and hot water mixture directly to the skin can lead to burns, so caution is advised.
Menthol-based oils, on the other hand, are a popular choice for congestion relief. These oils create a sensation of easier breathing but do not actually clear congested sinuses.
And, according to Dr. Buddy Creech, a pediatric infectious disease expert at the Vanderbilt University Medical Center in Nashville, Tennessee, stepping out into the cold air can help. Creech was quoted in an NBC interviews: “That coldness can constrict or tighten the blood vessels in the nose and that can actually cause them to get a little bit of relief.”
When to See a Doctor
Home remedies can go a long way to alleviating symptoms, but please see your doctor if:
- Your temperature is above 100.4°F (38°C)
- Symptoms are worsening
- Symptoms have not gone away after 10 days
- You experience frequent sinus issues
- Symptoms are not resolved with over-the-counter (OTC) medications
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